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Introduction to Liver Transplant

A liver transplant is a surgery to replace a diseased liver with a healthy liver from another person. A whole liver may be transplanted, or just part of one. In most cases the healthy liver will come from an organ donor who is brain dead.

The liver is the only organ in the body that can replace lost or injured tissue (regenerate). The donor’s liver will soon grow back to normal size after surgery. The part that is received as a new liver will also grow to normal size in a few weeks.

Need for Liver Transplant

A liver transplant may be offered to patients with the end-stage liver disease after other treatment options have been exhausted. Some of the common causes that lead to Liver transplant are:


Acute Liver Failure

Sustains 80 to 90% damage to the liver cells and may lead to coma

Viral Hepatitis

A highly contagious liver disease that causes the liver to fail completely

Alcoholic Liver Disease

Due to alcohol abuse, scars and cirrhosis occur causing the liver to stop functioning

Non-Alcoholic Fatty Liver Disease

Build-up of fat in the liver that causes inflammation and damages cells in the liver

Primary Liver Cancer

Cancer cells that have grown deep into the tissue halting any function of the liver

Types of Liver Transplant

There are three main ways a liver transplant can be carried out:

Deceased organ donation transplant – involves transplanting a liver that has been removed from a person who died recently

Living donor liver transplant – a section of liver is removed from a living donor; because the liver can regenerate itself, both the transplanted section and the remaining section of the donor’s liver are able to regrow into a normal-sized liver

Split donation transplant – a liver is removed from a person who died recently and is split into two pieces; each piece is transplanted into a different person, where they will grow to a normal size

Pre-Liver Transplant Evaluation

All patients wishing to undergo a Liver Transplant have to undergo a rigorous evaluation process. The specific tests, procedures and consultations one may undergo include:

Including routine cancer screening tests, to evaluate the overall health
Including blood and urine tests to assess the health of the organs, including the liver
Such as an ultrasound of the liver
To determine the health of the patient’s cardiovascular system
Who assess the nutritional status and make recommendations regarding nutritional intake before and after transplant
To assess and treat any underlying issues, such as depression or anxiety, and determine whether the patient fully understands the risks of a liver transplant

Legal Requirements

The primary legislation, Transplantation of Human Organs ACT, was passed in 1994. As per this act, there are certain guidelines to be followed for receiving a transplant depending on the country of residence of the receiver or the state of life of donor. For more information, visit Legalities section of our website.

The Liver Transplant Process

The general procedure that takes place during a liver transplant is:


General Anesthesia

The patient is put under general anesthesia to block and numb the pain


Incision is made to open up the abdominal area to access the liver

Evaluation of the abdomen

Evaluation of the abdomen for abnormalities to prevent liver transplant complications

Mobilization of the native liver

Mobilization of the native liver and isolation of important structures such as veins and arteries


Transection of the structures attached and removal of the native, diseased liver


New liver is attached, all blood vessels and bile ducts are connected before closing the incision

Adequate Control

Ensuring adequate control of bleeding and closure of the incision

Complications of Liver Transplant

Some of the main problems associated with liver transplants include:

  • The body rejecting the new liver
  • Bleeding (haemorrhage)
  • Bile Leakage
  • The new liver not working within the first few hours (primary non-function), requiring a new transplant to be carried out as soon as possible
  • An increased risk of picking up infections
  • Loss of kidney function
  • Problems with blood flow to and from the liver
  • An increased risk of certain types of cancer – particularly skin cancer

Post-Liver Transplant Procedure

After the surgery the patients are taken to the recovery room for a few hours before being taken to the intensive care unit (ICU). They are closely watched in the ICU for several days, and their vitals are monitored.

Blood samples will be taken often to check the new liver. The doctors will also check that the kidneys, lungs, and circulatory systems are all working. Anti-rejection medicines will be administered and closely watched to be sure that the patients are getting the right dose and the right mix of medicines.

When the doctors feel the patient is ready, they will be moved from the ICU to a normal ward. Patients will slowly be able to move about more and walk around for longer periods of time. The doctors will then teach them how to take care of themselves when they go home.

Life After Liver Transplant

Liver Transplant is a surgery that has saved countless lives around the world, and drastically improved the lives of people suffering from end stage liver disease. There are a few precautions that patients must keep in mind post-surgery.


Regular Follow Up

It is advised that patients regularly follow up with their doctors to monitor the progress of the liver transplant. These maybe frequent at first, but will gradually decline


The body may regard the new liver as foreign and attack it. Immunosuppressants prevent this from happening. Other drugs help reduce the risk of other complications after the transplant

Lifestyle Changes

Patients will need to alter their lifestyle drastically after the surgery. Patients cannot consume alcohol and need to watch the food they eat as well

Organ transplant success stories

Success Rate and Life Expectancy of Heart Transplant

As medicine progresses, so does the life expectancy of patients undergoing liver transplant. There have been great strides taken in the last decade or two, which have increased the success rate and the life expectancy of patients.


Success Rate: 88%


Life Expectancy:

Increased lifespan of 1 year: 86%
Increased lifespan of 3 years: 78%

Choosing the ideal liver transplant centre

It is imperative that patients learn about different transplant centres around them before zeroing in on any one of them. A few things to keep in mind while choosing a transplant centre are:

  • The centre/hospital’s reputation, mortality rates, technological expertise and team of doctors
  • Whether the centre/hospital accepts your insurance coverage
  • Locational advantage of getting to and from the patient’s home
  • Whether the transplant/centre has particular expertise in living donor transplants or deceased donor transplant
  • Consult more than one doctor and/or patients who have undergone a transplant in the centre and learn about their experience
  • The amount of experience the centre/hospital have in dealing with transplant cases

Analysing cost of a Liver Transplant

It’s important to consider the cost of any major surgery before a patient opts for it. For a person suffering from end-stage liver disease, sometimes an organ transplant is the only way to save the patient’s life.

It is suggested that patients check their insurance plans to check the coverage of the liver transplant. The cost of a liver transplant can range anywhere between 20 – 25 lakhs. This includes the pre-transplant evaluation, the surgery itself and the post-surgery recovery period. There are certain factors that affect the cost of an organ transplant.

  • Organ Recovery and Transport Charges
  • Hospital Infrastructure and Technology
  • Expertise of skilled surgeons, their teams and use of advanced techniques
  • Length of stay in the hospital and category of room opted
  • Any health complications
  • Recovery and Rehabilitation
  • Post-transplant Medication

Patients who don’t live in the vicinity of the hospital and/or have travelled from another city for the transplant also need to keep in mind the cost of stay in the new city. Most patients and their families opt to find a house on a short-term lease in close proximity to the hospital. These costs can add up over the course of a few months.

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